FIXES IN ORDER

In its annual budget summary Steele Memorial Medical Center Chief Financial Officer Jim Peterson told the Lemhi County Commissioners the report is not as positive as hoped but 2019 will be better.

The Monday, September 25, commissioner’s meeting was also attended by Chief Executive Officer Jeanie Gentry, Hospital Board Secretary Treasurer Kristin Troy and all members of the Steele Memorial Medical Center Hospital Board.

Gentry said the hospital has accomplished a lot during the past year, is looking forward to accomplishing more this coming year and, to not having another building project for a while. She said the budget has been reviewed with the hospital board and that she recommends it be approved by the commissioners.

Peterson said the focus for the coming year will be to modify current operations so that 2019 will be a better year than what is projected. He said a lot of ‘fixes’ have had to be done and he wishes he’d known about some of them before the new building project. He said the goal of paying off the bond early is still in place. The scheduled payoff date of the original bond is 2027.

The medical center’s number one expense is salary. Peterson said nursing salaries, as well as salaries across the board, had fallen way below average market levels and had to be brought up to date. He said most of the ills in the salary and wage scales were fixed in this current fiscal year and this week the remainder will be resolved.

The Medical Center is duty-bound to fulfill Medicare and Medicaid productivity levels for a rural health clinic. Peterson said Medicare would prefer the mid-level positions be staffed more than the physician level and with the recent departure of a physician Steele Memorial Medical Center levels are back to what the physician/mid-level-staff ratio was in 2015. He said that should serve as a self-fix until they are ready to hire another physician.

Peterson said, “I don’t like to bring a budget before the board or the commissioners that has a projected loss but it appears that that is where we’ll be in our restructure and re-building of our operation.”

County Commissioner Rick Snyder thanked the board and staff for all they have done and said, “We’ll get through this.” He changed the topic under discussion to “Time Sense Emergencies” and Kristin Troy explained the new program.

Troy said that last month the hospital completed a state survey and achieved a designation of a Trauma 4 facility. She said while the designation does help with reimbursements, the main thing is that local emergency cases can be presented to a regional team comprised of Emergency Services personnel, law enforcement and trauma experts. She said the program represents a quality of service improvement in that, a group of experts will systematically help to improve ways in which to deal with local trauma cases.

According to Troy, Idaho has been lagging behind surrounding states in the trauma designation program and small rural hospitals had not received such designations until a couple of years ago. She said most critical-access hospitals receive a Trauma 4 rating which is the lowest level for a hospital. The Challis Clinic is a Trauma level 5, Portneuf is a level 3, Idaho Falls and Twin Falls are level 2. There are different physician requirements at each level and Troy said they are very proud of the effort put forth by local emergency room doctors to achieve the newly acquired designation.

Snyder commented it is a great advantage for local residents. He said in the event of a car accident, first responders on the scene relay a code to the hospital so that the appropriate provider can be alerted and the right people will be on hand at the hospital and prepared to receive the patient.

Troy went on to say that earlier this month, for the first time in over six years, the state came in to assess the hospital’s Medicaid and Medicare compliance. If rules aren’t followed Medicare won’t pay. She was happy to report the hospital passed.

Peterson said the old clinic building is quickly filling with specialists who make regular visits to the area. In answer to a question from Commissioner Chairman Ken Miner, Troy said that with the new meeting rooms the traffic count has definitely increased but as yet has not translated into more patient visits. She and Snyder agreed the Urgent Care Center is very popular.

Peterson added that the hospital has seen on average, a steady increase of 2,000 patients per year.

The Lemhi County Commissioners approved a motion to accept the Steele Memorial Hospital Clinic budget for 2018 as presented.